Implementation of laparoscopic methods in the quality assurance of the emergency surgical service: Doctor of Medical Sciences Dissertation Summary: 331.03 – Social medicine and management

Abstract

The emergency surgical service is a health service provided by an PHMI, which deals with the interventional treatment of patients who need immediate and urgent medical care for surgical conditions. This service covers a wide range of pathologies, including serious trauma and other surgical emergencies, including the acute abdomen (AA), which remains a frequent surgical emergency in the work of doctors, representing a spectrum of pathologies, which requires immediate evaluation in order to argue the tactics of treatment [1]. The prompt diagnosis of surgical AA is essential, ensuring the avoidance of unjustified delay in treatment that influences the patient's prognosis [11, 12, 15]. One of the basic paraclinical investigations is laparoscopy (LS) - an invasive exploration introduced into the current practice of urgent surgery, which ensured the reduction of unsubstantiated laparotomies (LT) [17]. Renz BM. and Feliciano DV., examining the morbidity after diagnostic laparotomy, demonstrated that 41.3% patients developed complications, and diagnostic laparoscopy in the acute abdomen presented a complication risk of 3.6% [31]. The causes of the fulminant development of laparoscopic surgery were: the advantages of laparoscopy determined by the improvement of the postoperative evolution, less pain in intensity and duration, early mobilization, early feeding, reduction of the hospitalization and recovery period, the aesthetic benefit, a lower rate of postoperative complications compared to traditional surgical techniques [2, 4]. These advantages facilitated the identification of the quality criteria provided to the patient, and the economic evaluation of the case treated with the application of the laparoscopic technique demonstrated that the cost-effectiveness of laparoscopy at the institutional level has an imposing economic impact [9,18]. [...]